Journal of Diagnostics Concepts & Practice >
Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly
Received date: 2019-01-21
Online published: 2019-04-25
Objective: ACE is the key enzyme of renin-angiotension-aldosterone system(RAAS). The insertion (I allele) deletion (D allele) polymorphism of ACE gene determines the serum level of ACE. There are three genotypes including DD, ID and II. The aim of this study was to study the possible impact of this polymorphism on risk of renal function decline in Chinese elderly people. Methods: A total of 366 elderly patients from geriatrics department of Ruijin Hospital in 2010 was enrolled. Medical history (hypertension and diabetes) was collected, weight and the basic clinical characteristics were measured. Polymerase chain reaction (PCR) was used to determine the ACE genotypes (ID, II, DD). Patients were followed up in 2011 and 2016. After excluding the dead and those lost to follow-up, 152 cases were remained for analysis. These patients were divided into two groups according to the ACE genotypes, the group DD+ID and the group II. Results: Retrospective analysis showed that the 6 years follow-up demonstrated a trend of decline of weight and creatinine clearance rate(Ccr)(P<0.05) and a trend of rising of fast blood glucose level(P<0.05). There were no significant differences in fast blood lipid level, the incidence of diabetes and hypertension(P>0.05). There were no significant differences between group DD+ID and group II for weight, sex, age, fast blood glucose level, fast blood lipid level, incidence of diabetes and hypertension (P>0.05). Group DD+ID had more decline of Ccr than group II(P<0.05). Conclusions: The D allele of ACE gene is a risk factor of decline of kidney function in Chinese elderly people.
Key words: Angiotensin converting enzyme; Gene polymorphism; Renal function; Elderly
WU Lin, ZHENG Ge, TAO Ting . Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(2) : 204 -208 . DOI: 10.16150/j.1671-2870.2019.02.016
[1] | Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey[J]. Lancet, 2012, 379(9818):815-822. |
[2] | Rigat B, Hubert C, Alhene-Gelas F, et al. An insertion/deletion polymorphism in the angiotensin I-converting enzyme gene accounting for half the variance of serum enzyme levels[J]. J Clin Invest, 1990, 86(4):1343-1346. |
[3] | Wascher TC, Dittrich P, Toplak H, et al. Endothelial dysfunction in hypertension[J]. Lancet, 1994, 344(8921):549-550. |
[4] | Lin C, Yang HY, Wu CC, et al. Angiotensin-converting enzyme insertion/deletion polymorphism contributes high risk for chronic kidney disease in Asian male with hypertension--a meta-regression analysis of 98 observational studies[J]. PLoS One, 2014, 9(1):e87604. |
[5] | 程洁, 黄钟声, 刘艳明, 等. 血管紧张素Ⅰ转化酶及血管紧张素Ⅱ受体1型基因多态性与糖尿病肾病的关联研究[J]. 临床肾脏病杂志, 2016, 16(5):286-289. |
[6] | Liu X, Cheng MH, Shi CG, et al. Variability of glomerular filtration rate estimation equations in elderly Chinese patients with chronic kidney disease[J]. Clin Interv Aging, 2012, 7:409-415. |
[7] | 中华医学会老年医学分会肾病学组, 国家老年疾病临床医学研究中心. 老年人慢性肾脏病诊治中国专家共识( 2018)[J]. 中华老年医学杂志, 2018, 37(7):725-731. |
[8] | 陈秀梅, 卢新政. ACE基因I/D多态性在心血管疾病中的研究进展[J]. 国际遗传学杂志, 2008, 31(6):471-474. |
[9] | Suzuki Y, Ruiz-Ortega M, Gomez-Guerrero C, et al. Angiotensin Ⅱ, the immune system and renal diseases: ano-ther road for RAS?[J]. Nephrol Dial Transplant, 2003, 18(8):1423-1426. |
[10] | Fabris B, Bortoletto M, Candido R, et al. Genetic polymorphisms of the renin-angiotensin-aldosterone system and renal insufficiency in essential hypertension[J]. J Hypertens, 2005, 23(2):309-316. |
[11] | 高妍婷, 李振江, 王晓明, 等. 血管紧张素转换酶基因多态性与2型糖尿病肾脏疾病的相关性研究[J]. 陕西医学杂志, 2014, 43(10):1283-1286. |
[12] | de Azevedo MJ, Dalmáz CA, Caramori ML, et al. ACE and PC-1 gene polymorphisms in normoalbuminuric Type 1 diabetic patients: a 10-year prospective study[J]. J Dia-betes Complications, 2002, 16(4):255-262. |
[13] | Lee YT, Chiu HC, Su HM, et al. The D allele of angiotensin-converting enzyme polymorphism as a predictor of renal function decline over 4 years in an apparently healthy Chinese population aged 60 and older[J]. J Am Geriatr Soc, 2008, 56(4):718-723. |
[14] | Shanmuganathan R, Kumaresan R, GiriP. Prevalence of angiotensin converting enzyme(ACE) gene insertion/deletion polymorphism in South Indian population with hypertension and chronic kidney disease[J]. J Postgrad Med, 2015, 61(4):230-234. |
[15] | Jindal A, Garcia-Touza M, Jindal N, et al. Diabetic kidney disease and the cardiorenal syndrome: old disease, new perspectives[J]. Endocrinol Metab Clin North Am, 2013, 42(4):789-808. |
[16] | 龚洪涛, 马先林, 杜凤和. 血管紧张素转换酶和醛固酮合成酶基因多态性与原发性高血压病的关系研究[J]. 中国全科医学, 2011, 14(8B):2609-2611. |
/
〈 |
|
〉 |